What is lupus and is it serious?

Written by Liu Li Ning
Rheumatology
Updated on December 14, 2024
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Lupus erythematosus is an autoimmune disease, which can be very severe in some cases and mild in others. For example, cutaneous lupus erythematosus generally does not involve major organs and usually presents with mild symptoms, primarily affecting the skin and mucous membranes. However, systemic lupus erythematosus can affect significant organs like the kidneys and heart in many patients, often leading to severe medical conditions. Especially, patients with rapidly progressive glomerulonephritis and those with coronary atherosclerotic heart disease tend to have a higher mortality rate. If systemic lupus erythematosus is diagnosed, it is crucial to receive standardized treatment early. Typically, treatment involves long-term maintenance with corticosteroids and immunosuppressants to control the progression of the disease and reduce the likelihood of mortality.

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Written by Liu Li Ning
Rheumatology
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What should I do about lupus erythematosus?

Lupus erythematosus requires early and formal treatment to stabilize the condition. For mild cutaneous lupus erythematosus, topical immunosuppressants, such as tacrolimus ointment, and immunomodulators, such as hydroxychloroquine, can be used. Low-dose corticosteroids may be necessary for combination therapy. Systemic lupus erythematosus generally requires corticosteroids as the basis of treatment, combined with one or several immunosuppressants to effectively control the disease. Systemic lupus erythematosus often involves multiple organs, with the kidneys, hematological system, and lungs being the most common. Therefore, it is necessary to use corticosteroids in combination with immunosuppressants to control the progression of the disease, as using only immunomodulators is often insufficient.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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What should I do if lupus causes a cold and cough?

When patients with lupus erythematosus experience a cold and cough, we should first conduct a routine blood test to see if it is caused by an infection, and then treat the symptoms accordingly. If the patient has a cough with phlegm, we should first help the patient clear the phlegm to avoid choking. Patients with lupus erythematosus should not take medication at will. If medication is needed to treat the cold and cough, it should be used under the guidance of a doctor.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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Can lupus patients get pregnant?

Patients with lupus can conceive normally, but it is not recommended to become pregnant. This is because patients with lupus who become pregnant are prone to miscarriage, preterm birth, stillbirth, and poor fetal development in the uterus, especially in patients who are positive for antiphospholipid antibodies. Pregnancy can also aggravate the disease or cause a relapse in lupus patients, and even if the disease is stable, there are cases where the condition worsens during pregnancy or after childbirth. Therefore, it is not recommended for patients with active systemic lupus erythematosus to become pregnant. If the condition has been stable for more than a year after treatment and the patient has been off medication for at least 6 months, then pregnancy can be considered. However, it is important to note that dexamethasone, immunosuppressants, and Tripterygium wilfordii tablets have side effects on the fetus and should be avoided.

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Written by Liu Li Ning
Rheumatology
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Does lupus erythematosus transmit through living and eating together?

Lupus erythematosus is not contagious through sharing meals or living together. It is an autoimmune disease, not an infectious one, hence it cannot be transmitted to others by living or eating together. The exact mechanism of lupus is currently unclear, but it may be related to various factors such as sex hormones, genetics, infections, and physical and chemical factors, and it is more commonly seen in females. Clinically common symptoms include fever, rash, joint pain, oral ulcers, hair loss, etc. The clinical manifestations vary depending on the affected target organ. If lupus nephritis occurs, symptoms such as edema can appear. If the lungs are involved, it can promote pulmonary interstitial fibrosis, and in severe cases, patients may experience chest tightness, shortness of breath, and breathing difficulties.

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Written by Liu Li Ning
Rheumatology
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What does the early rash of lupus look like?

The early characteristic rash of lupus erythematosus is typically a butterfly-shaped rash on the face. Other common presentations include palm and periungual erythema, discoid rash, nodular erythema, and livedo reticularis. If the rash is not notably itchy, it generally indicates lupus erythematosus. If there is significant itching, it may suggest the possibility of an allergic factor active in the disease. After immunosuppression, itchy rashes should be monitored for possible fungal infections. The specific pathogenesis of systemic lupus erythematosus is still unclear. If a patient exhibits the typical butterfly-shaped rash on the face, systemic lupus erythematosus should be highly suspected. Testing for antinuclear antibodies, and specifically for anti-Sm and double-stranded DNA antibodies, which represent a variety of autoantibodies, can diagnose systemic lupus erythematosus.